<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_jccm-2020-0020_s_006_w2aab3b7ab1b6b1aab1c16b1Aa"><h3>Introduction</h3><p>Variations in the expression of vascular endothelial growth factor (VEGF) could be used as a biomarker in critically ill patients with sepsis and septic shock. Inflammation potently upregulates VEGF-C expression via macrophages with an unpredictable response. This study aimed to assess one of the newer biomarkers (VEGF-C) in patients with sepsis or septic shock and its clinical value as a diagnostic and prognostic tool.</p></sec><sec id="j_jccm-2020-0020_s_007_w2aab3b7ab1b6b1aab1c16b2Aa"><h3>Material and methods</h3><p>The study involved 142 persons divided into three groups. Group A consisted of fifty-eight patients with sepsis; Group B consisted of forty-nine patients diagnosed as having septic shock according to the Sepsis -3 criteria. A control group of thirty-five healthy volunteers comprised Group C. Severity scores, prognostic score and organ dysfunction score, were recorded at the time of enrolment in the study. The analysis included specificity and sensitivity of plasma VEGF-C for diagnosis of septic shock. Circulating plasma VEGF-C levels were correlated with the APACHE II, MODS and severity scores and mortality.</p></sec><sec id="j_jccm-2020-0020_s_008_w2aab3b7ab1b6b1aab1c16b3Aa"><h3>Results</h3><p>The mean (SD) plasma VEGF-C levels in septic shock patients (1374(789) pg./m), on vasopressors at the time of admission to the ICU, were significantly higher 1374(789)pg./mL, compared the mean (SD) plasma VEGF-C levels in sepsis patients (934(468) pg./mL); (p = 0.0005, Student’s t-test.) Plasma VEGF-C levels in groups A and B were shown to be significantly correlated with the APACHE II (r = 0.21, p = 0.02; r = 0.45, p = 0.0009) and MODS score (r = 0.29, p = 0.03; r = 0.4, p = 0.003). There was no association between plasma VEGF-C levels and mortality [p = 0.1]. The cut-off value for septic shock was 1010 pg./ml.</p></sec><sec id="j_jccm-2020-0020_s_009_w2aab3b7ab1b6b1aab1c16b4Aa"><h3>Conclusions</h3><p>VEGF-C may be used as a prognostic marker in sepsis and septic shock due to its correlation with APACHE II values and as an early marker to determine the likelihood of developing MODS. It could be used as an early biomarker for diagnosing patients with septic shock.</p></sec></abstract>

IntroductionVariations in the expression of vascular endothelial growth factor (VEGF) could be used as a biomarker in critically ill patients with sepsis and septic shock. Inflammation potently upregulates VEGF-C expression via macrophages with an unpredictable response. This study aimed to assess one of the newer biomarkers (VEGF-C) in patients with sepsis or septic shock and its clinical value as a diagnostic and prognostic tool.Material and methodsThe study involved 142 persons divided into three groups. Group A consisted of fifty-eight patients with sepsis; Group B consisted of forty-nine patients diagnosed as having septic shock according to the Sepsis -3 criteria. A control group of thirty-five healthy volunteers comprised Group C. Severity scores, prognostic score and organ dysfunction score, were recorded at the time of enrolment in the study. The analysis included specificity and sensitivity of plasma VEGF-C for diagnosis of septic shock. Circulating plasma VEGF-C levels were correlated with the APACHE II, MODS and severity scores and mortality.ResultsThe mean (SD) plasma VEGF-C levels in septic shock patients (1374(789) pg./m), on vasopressors at the time of admission to the ICU, were significantly higher 1374(789)pg./mL, compared the mean (SD) plasma VEGF-C levels in sepsis patients (934(468) pg./mL); (p = 0.0005, Student’s t-test.) Plasma VEGF-C levels in groups A and B were shown to be significantly correlated with the APACHE II (r = 0.21, p = 0.02; r = 0.45, p = 0.0009) and MODS score (r = 0.29, p = 0.03; r = 0.4, p = 0.003). There was no association between plasma VEGF-C levels and mortality [p = 0.1]. The cut-off value for septic shock was 1010 pg./ml.ConclusionsVEGF-C may be used as a prognostic marker in sepsis and septic shock due to its correlation with APACHE II values and as an early marker to determine the likelihood of developing MODS. It could be used as an early biomarker for diagnosing patients with septic shock.

The Diagnostic and Prognostic Role of Vascular Endothelial Growth Factor C in Sepsis and Septic Shock

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

IntroductionVariations in the expression of vascular endothelial growth factor (VEGF) could be used as a biomarker in critically ill patients with sepsis and...

Variables	Group A	Group B	P value
qSOFA score (median)	2	2	>0.999
SOFA (median, score range)	5 (0-16)	8 (0-18)	<0.0001
MODS (median, score range)	4.9 (0-10)	9.2 (2-18)	<0.0001
APACHE (median, II range) score	17 (6-39)	23 (5-39)	<0.0001

Variables	Group A	Group B	P-value
Age(years)	65(68)	69(56)	0.17 Mann-Whitney test
median (range)
Gender, male (n, %)	35(60%)	22(44%)
Gender, female (n, %)	23(40%)	27(56%)	0.12 Chi-square test

The Diagnostic and Prognostic Role of Vascular Endothelial Growth Factor C in Sepsis and Septic Shock

Article Category: Research Article

Publicado en línea: 11 ago 2020

Páginas: 152 - 158

Recibido: 20 ago 2019

Aceptado: 23 abr 2020

DOI: https://doi.org/10.2478/jccm-2020-0020

Palabras clave
vascular endothelial growth factor C, sepsis, septic shock, lymphangiogenesis

© 2020 Emoke Almasy, Janos Szederjesi, Bianca Liana Grigorescu, Iudita Badea, Marius Petrisor, Cristina Manasturean, Valentina Negrea, Agota-Evelyn Timar, Oana Coman, Leonard Azamfirei, Ario Santini, Sanda Maria Copotoiu, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

Fig. 2

qSOFA, SOFA, MODS, APACHE II scores in Groups A and B

Demographic data and length of stay in ICU for Group A (sepsis) and Group B (septic shock)

The Diagnostic and Prognostic Role of Vascular Endothelial Growth Factor C in Sepsis and Septic Shock

Article Category: Research Article

Publicado en línea: 11 ago 2020

Páginas: 152 - 158

Recibido: 20 ago 2019

Aceptado: 23 abr 2020

DOI: https://doi.org/10.2478/jccm-2020-0020

Palabras clavevascular endothelial growth factor C, sepsis, septic shock, lymphangiogenesis

© 2020 Emoke Almasy, Janos Szederjesi, Bianca Liana Grigorescu, Iudita Badea, Marius Petrisor, Cristina Manasturean, Valentina Negrea, Agota-Evelyn Timar, Oana Coman, Leonard Azamfirei, Ario Santini, Sanda Maria Copotoiu, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1

Fig. 2

qSOFA, SOFA, MODS, APACHE II scores in Groups A and B

Demographic data and length of stay in ICU for Group A (sepsis) and Group B (septic shock)

Palabras clave
vascular endothelial growth factor C, sepsis, septic shock, lymphangiogenesis